BILL NUMBER:S4792

TITLE OF BILL:  An act to amend the public health law, in relation to
orders not to resuscitate; and to repeal article 29-B of the public
health law relating to orders not to resuscitate for residents of
mental hygiene facilities

PURPOSE:  This is one of a series of seven bills, informally referred
to as the "Surrogate Decision-Making Improvement Acts." The bills make
technical/minor, clarifying and coordinating amendments and other
improvements to the NYS laws that govern health care decisions,
including life-sustaining treatment decisions, for patients who lack
decision-making capacity. The SDMIAs address these topics:

*SDMIA 1 Technical / Minor Amendments

*SDMIA 2 Repeals PHL Art. 29-B Orders Not to Resuscitate for Patients
in Mental Hygiene Facilities

*SDMIA 3 Determining Patient Incapacity

*SDMIA 4 Decisions by a Health Care Agent About Artificial Nutrition
and Hydration

*SDMIA 5 Confirm the Primacy of a Patient's Clear Prior Decision

              

*SDMIA 6 Restore Medical Futility as a Basis for a DNR Order

*SDMIA 7 Life-Sustaining Treatment Decisions for Developmentally
Disabled Persons

This bill, SDMIA 2 repeals PHL Art. 29-B Orders Not to Resuscitate for
Patients in Mental Hygiene Facilities.

SUMMARY OF PROVISIONS:

Section 1 repeals Public Health Law Article 29-B.

Section 2 amends § 2994-b to add subdivision 1-a to make the FHCDA
applicable to decisions regarding orders not to resuscitate for a
patient in an OMH licensed psychiatric hospitals and psychiatric units
of general hospitals.

Section 3 amends PHL § 2994-cc(5) to delete a reference to PHL Article
29-B. Section 4 amends PHL § 2994-ff to delete a reference to PHL
Article 29-B. Section 5 sets forth the effective date.

JUSTIFICATION:  This bill repeals PHL Art 29-B Orders Not To
Resuscitate For Residents Of Mental Hygiene Facilities.

Prior to 2010, PHL Art. 29-B governed DNR orders in hospitals, nursing
homes, mental hygiene facilities and elsewhere. Ch. 8, L. 2010 (i)
replaced the DNR Law with the FHCDA in hospitals and nursing homes,
(ii) amended PHL Art. 29-B to make it applicable only to residents of
mental hygiene facilities, i.e., psychiatric hospitals, psychiatric
units of general hospitals, and OPWDD operated developmental centers,


and (iii) created PHL Art. 29-CCC - Nonhospital Orders Not To
Resuscitate, to cover all other settings.

It soon became clear that there is no need for a separate DNR law for
residents of mental hygiene facilities. First, DNR orders for
residents of OPWDD-operated developmental centers were already
governed by SCPA § 1750-b, making PHL Art. 29-B redundant. Second, DNR
orders in psychiatric hospitals and general hospital mental health
units were more appropriately governed by the provisions in the FHCDA.
Moreover variations in DNR procedures and standards especially between
the procedures and standards in hospital medical units and hospital
mental health units have become a source of confusion and complexity.

Accordingly section 1 of this bill repeals PHL Art. 29-B. Related
amendments in this bill provide that DNR decisions for patients in
psychiatric hospitals and units are governed by the FHCDA and confirm
that DNR decisions for all persons with developmental disabilities are
governed by SCPA 1750-b (§§ 2 - 4).

LEGISLATIVE HISTORY:  S.7152 of 2014 S.5321 (Sen. Hannon) (2013)/
A.7371 (M. of A. Gottfried)(2013) included all of these provisions, as
well as other provisions.

FISCAL IMPLICATIONS: None.

EFFECTIVE DATE:  This act shall take effect on the ninetieth day after
it shall have become a law.